First Mexican Consensus on Crohn's disease.

INTRODUCTION: Crohn's disease (CD) is a subtype of chronic and incurable inflammatory bowel disease. It can affect the entire gastrointestinal tract and its etiology is unknown. OBJECTIVE: The aim of this consensus was to establish the most relevant aspects related to definitions, diagnosis, follow-up, medical treatment, and surgical treatment of Crohn's disease in Mexico. MATERIAL AND METHODS: Mexican specialists in the areas of gastroenterology and inflammatory bowel disease were summoned. The consensus was divided into five modules, with 69 statements. Applying the Delphi panel method, the pre-meeting questions were sent to the participants, to be edited and weighted. At the face-to-face meeting, all the selected articles were shown, underlining their level of clinical evidence; all the statements were discussed, and a final vote was carried out, determining the percentage of agreement for each statement. RESULTS: The first Mexican consensus on Crohn's disease was produced, in which recommendations for definitions, classifications, diagnostic aspects, follow-up, medical treatment, and surgical treatment were established. CONCLUSIONS: Updated recommendations are provided that focus on definitions, classifications, diagnostic criteria, follow-up, and guidelines for conventional medical treatment, biologic therapy, and small molecule treatment, as well as surgical management.

The Mexican consensus on the diagnosis and treatment of ulcerative colitis. / Consenso mexicano para el diagnóstico y tratamiento de la colitis ulcerosa crónica idiopática.

The guidelines presented herein are an updated version of the recommendations published in 2007. Since then, there has been a rapid advance in the knowledge about the pathophysiology of ulcerative colitis and its therapeutic options. New drugs have been approved, novel targeted therapies have emerged, and new strategies have been developed to improve the previously available approaches to the disease. The aim of the present consensus is to promote the current knowledge of and Mexican perspective on the epidemiology, diagnosis, and medical and surgical treatment of chronic idiopathic ulcerative colitis. The final vote on the statements and their ultimate modifications were carried out at the consensus working group meeting. Evidence was evaluated through the GRADE classification.

Exploring the potential of Burkholderia sacchari to produce polyhydroxyalkanoates.

AIM: Evaluation of the capability of Burkholderia sacchari to incorporate different monomers into polyhydroxyalkanoates (PHA). METHODS AND RESULTS: Thirty different carbon sources were evaluated as cosubstrates for B. sacchari growing on glucose with the intention to promote the incorporation of different monomers into the PHA produced by this species. With odd-numbered fatty acids, incorporation of the 3HV monomer was achieved, up to 65 mol% in the case of valerate. With 4-hydroxybutyrate, incorporation of 4HB was obtained, representing 9·1 mol%. With hexanoic acid, the production of P3HB-co-3HHx was achieved, containing up to 1·6 mol% of 3HHx. The molar fraction of 3HHx was found to be dependent on the ratio of glucose to hexanoic acid supplied. Metabolic flux analysis revealed a high efficiency of B. sacchari in converting carbon sources into P3HB-co-3HHx. Nevertheless, hexanoic acid was only poorly converted to 3HHx. CONCLUSIONS: Burkholderia sacchari is able to incorporate 3HV, 4HB and 3HHx in PHA containing mainly 3HB. The 3HHx content of P3HB-co-3HHx can be controlled by varying the glucose to hexanoic acid ratio. Burkholderia sacchari is highly efficient in converting carbon sources into PHA; however, only 2% of the hexanoic acid supplied could be converted to 3HHx. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report describing an approach to modulate the composition of P3HB-co-3HHx produced by bacteria using mixtures of carbohydrate and hexanoic acid as carbon source.

Role of CcpA in polyhydroxybutyrate biosynthesis in a newly isolated Bacillus sp. MA3.3.

The ccpA gene was inactivated in the polyhydroxybutyrate (PHB)-producing strain Bacillus sp. MA3.3 in order to reduce glucose catabolite repression over pentoses and develop improved bacterial strains for the production of PHB from lignocellulosic hydrolysates. Mutant Bacillus sp. MSL7 ΔCcpA are unable to grow on glucose and ammonia as sole carbon and nitrogen sources, respectively. Supplementation of glutamate as the nitrogen source or the substitution of the carbon source by xylose allowed the mutant to partially recover its growth performance. RT-PCR showed that CcpA stimulates the expression of the operon (gltAB),responsible for ammonia assimilation via glutamate in Bacillus sp. MA3.3. Moreover, it was demonstrated that the supplementation of xylose or glutamate was capable of stimulating gltAB operon expression independently of CcpA. In PHB production experiments in mineral media, it has been observed that the glucose catabolite repression over the pentoses was partially released in MSL7. Although the carbohydrate consumption is faster in the ccpA mutant, the biomass and PHB biosynthesis are lower, even with supplementation of glutamate. This is attributed to an increase of acetyl-CoA flux towards the tricarboxylic acid cycle observed in the mutant.

PHA(MCL) biosynthesis systems in Pseudomonas aeruginosa and Pseudomonas putida strains show differences on monomer specificities.

The production of PHA from plant oils by Pseudomonas species soil isolated from a sugarcane crop was evaluated. Out of 22 bacterial strains three were able to use efficiently plant oils to grow and to accumulate PHA. Pseudomonas putida and Pseudomonas aeruginosa strains produced PHA presenting differences on monomer composition compatible with variability on monomer specificity of their PHA biosynthesis system. The molar fraction of 3-hydroxydodecanoate detected in the PHA was linearly correlated to the oleic acid supplied. A non-linear relationship between the molar fractions of 3-hydroxy-6-dodecenoate (3HDdDelta(6)) detected in PHA and the linoleic acid supplied was observed, compatible with saturation in the biosynthesis system capability to channel intermediate of beta-oxidation to PHA synthesis. Although P. putida showed a higher 3HDdDelta(6) yield from linoleic acid when compared to P. aeruginosa, in both species it was less than 10% of the maximum theoretical value. These results contribute to the knowledge about the biosynthesis of PHA with a controlled composition from plant oils allowing in the future establishing the production of these polyesters as tailor-made polymers.

[Relationship between methylenetetrahydrofolate reductase polymorphism and homocysteine levels in women with recurrent pregnancy loss: a nutrigenetic perspective]. / Relación entre los polimorfismos de la metilen-tetrahidrofolato-reductasa y los niveles de homocisteína en mujeres con pérdida gestacional recurrente: perspectiva desde la nutrigenética.

The objective of this study was to evaluate if there is any difference in the proportion of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms and the homocysteine levels in a group of women with recurrent pregnancy loss (RPL) and a control group. Ninety-three patients with diagnosis of three or more gestational losses and 206 healthy women with two or more children, were included. After acceptance of informed consent, samples of peripheral blood were taken to determine the genetic polymorphisms of MTHFR C677T and the plasmatic levels of homocysteine. The carriers of the homozygous mutation TT of MTHFR 677T polymorphism were 12.9% (12 of 93) in the group of patients and 14.6% (30 of 206) in the control group; 46.2% (43 of 93) and 40% (83 of 206) in the group of patients and controls respectively, were heterozygous CT for MTHFR gene. The levels of homocysteine were 7.2 micromol/ml in the group of patients and 7.7 mmol/l in controls. There was no relationship between MTHFR gene polymorphisms and the increase of homocysteine levels, nor of these one with RPL. From the nutrigenetics perspective we suggest that studies related to MTHFR polymorphisms and the risk of disease include the levels of folate and B6 and B12 vitamins participating in the tetrahydrofolate cycle for trying to establish a direct relation among the genotype, the level of metabolite and the clinical manifestations. In this regard, we recommend the administration of folic acid in women in search of pregnancy due to the high frequency of heterozygous and homozygous for MTHFR C677T mutation in our population.

Generation of entangled states of qudits using twin photons.

We report an experiment to generate entangled states of D-dimensional quantum systems, qudits, by using transverse spatial correlations of two parametric down-converted photons. Apertures with D slits in the arms of the twin photons define the qudit space. By manipulating the pump beam correctly, the twin photons will pass only by symmetrically opposite slits, generating entangled states between these different paths. Experimental results for qudits with D = 4 and 8 are shown. We demonstrate that the generated states are entangled states.

Poly-3-hydroxybutyrate (P3HB) production by bacteria from xylose, glucose and sugarcane bagasse hydrolysate.

Fifty-five bacterial strains isolated from soil were screened for efficient poly-3-hydroxybutyrate (P3HB) biosynthesis from xylose. Three strains were also evaluated for the utilization of bagasse hydrolysate after different detoxification steps. The results showed that activated charcoal treatment is pivotal to the production of a hydrolysate easy to assimilate. Burkholderia cepacia IPT 048 and B. sacchari IPT 101 were selected for bioreactor studies, in which higher polymer contents and yields from the carbon source were observed with bagasse hydrolysate, compared with the use of analytical grade carbon sources. Polymer contents and yields, respectively, reached 62% and 0.39 g g(-1) with strain IPT 101 and 53% and 0.29 g g(-1) with strain IPT 048. A higher polymer content and yield from the carbon source was observed under P limitation, compared with N limitation, for strain IPT 101. IPT 048 showed similar performances in the presence of either growth-limiting nutrient. In high-cell-density cultures using xylose plus glucose under P limitation, both strains reached about 60 g l(-1) dry biomass, containing 60% P3HB. Polymer productivity and yield from this carbon source reached 0.47 g l(-1) h(-1) and 0.22 g g(-1), respectively.

Identification of the 2-methylcitrate pathway involved in the catabolism of propionate in the polyhydroxyalkanoate-producing strain Burkholderia sacchari IPT101(T) and analysis of a mutant accumulating a copolyester with higher 3-hydroxyvalerate content.

Burkholderia sacchari IPT101(T) induced the formation of 2-methylcitrate synthase and 2-methylisocitrate lyase when it was cultivated in the presence of propionic acid. The prp locus of B. sacchari IPT101(T) is required for utilization of propionic acid as a sole carbon source and is relevant for incorporation of 3-hydroxyvalerate (3HV) into copolyesters, and it was cloned and sequenced. Five genes (prpR, prpB, prpC, acnM, and ORF5) exhibited identity to genes located in the prp loci of other gram-negative bacteria. prpC encodes a 2-methylcitrate synthase with a calculated molecular mass of 42,691 Da. prpB encodes a 2-methylisocitrate lyase. The levels of PrpC and PrpB activity were much lower in propionate-negative mutant IPT189 obtained from IPT101(T) and were heterologously expressed in Escherichia coli. The acnM gene (ORF4) and ORF5, which are required for conversion of 2-methylcitric acid to 2-methylisocitric acid in Ralstonia eutropha HF39, are also located in the prp locus. The translational product of ORF1 (prpR) had a calculated molecular mass of 70,598 Da and is a putative regulator of the prp cluster. Three additional open reading frames (ORF6, ORF7, and ORF8) whose functions are not known were located adjacent to ORF5 in the prp locus of B. sacchari, and these open reading frames have not been found in any other prp operon yet. In summary, the organization of the prp genes of B. sacchari is similar but not identical to the organization of these genes in other bacteria investigated recently. In addition, this study provided a rationale for the previously shown increased molar contents of 3HV in copolyesters accumulated by a B. sacchari mutant since it was revealed in this study that the mutant is defective in prpC.

Polyhydroxyalkanoate-accumulating bacterium isolated from soil of a sugar-cane plantation in Brazil.

Strain IPT101T, isolated from the soil of a sugar-cane plantation in Brazil, was analysed in a polyphasic taxonomic study. The strain produces polyhydroxyalkanoates from sucrose and other carbon sources. Morphological, physiological and biochemical data as well as 16S rDNA, whole-cell protein and fatty acid analyses indicated that strain IPT101T represents a new species in the genus Burkholderia. The name Burkholderia sacchari sp. nov. is proposed, with strain IPT101T (= LMG 19450T = CCT 6771T) as the type strain.

Propionic acid metabolism and poly-3-hydroxybutyrate-co-3-hydroxyvalerate (P3HB-co-3HV) production by Burkholderia sp.

Mutants of Burkholderia sp. that are unable to grow on propionic acid (prp) but still accumulate P3HB-co-3HV from carbohydrate and propionic acid were studied. In shaken flask tests, yields of 3HV from propionic acid (Y(3HV/Prop)) increased from 0.10 g g(-1) in the wild type to c.a. 0.35 g g(-1) in mutants affected in alpha-oxidation pathway or to 0.80 g g(-1) in mutants not affected in that pathway. In bioreactor tests, mutant IPT 189 showed Y(3HV/Prop) = 1.20 g g(-1), a yield very close to the theoretical maximum of 1.35 g g(-1). Accumulation of 3HV units from unrelated carbon sources was undetectable in these mutants indicating that 3HV units are produced directly from propionic acid. Thus, the industrial use of those mutants to produce the copolymer from sucrose and propionic acid could significantly reduce the production costs. The results strongly suggest the existence of at least two pathways that are involved in the oxidation of propionic acid in Burkholderia sp. Their rates would be modulated by the availability of propionic acid.

Was Julius Caesar's epilepsy due to a brain tumor?

Two thousand thirty-eight years later, in the setting of a similar care presentation, a physician would take a detailed history and perform a clinical and neurological examination. A preliminary diagnosis would be entertained and followed by electroencephalography and magnetic resonance of the brain with and without paramagnetic contrast for diagnostic confirmation. The proper medical or surgical treatment would then be instituted. A reconstruction of the clinical history of Julius Caesar (100-44 B.C.) has been attempted from available information from literature. Although a definite conclusion obviously cannot be made, a differential diagnosis provided with a tentative hypothesis is presented. The patient had late onset of seizures in the last two years of his life, headaches, personality changes. Upon reexamination of existing Julius Caesar iconography, busts, statues and minted coins no skull deformities have been noted. Identification of a skull deformity as described by Suetonius would have confirmed the suspicion of meningioma involving the convexity of the cerebral hemispheres. Meningioma or slow-growing supratentorial glioma may well have been responsible for this man's illness. Who knows how the course of history might have been changed... Probably not at all.

Conjoined lumbosacral nerve roots.

Conjoined lumbosacral nerve roots is a congenital anomaly that may produce lumbosciatic pain. When symptomatic and undiagnosed, it may be one of the causes of failed back syndrome. Diagnosis with water-soluble contrast myelography has a frequency of 4%. Anatomical studies have shown to have an incidence of 14%. High quality Magnetic Resonance Imaging (MRI) with coronal views may reveal this condition without recurring to computed tomography (CT)-myelography. In this paper we describe our recent experience with five consecutive cases observed during a one year period.

Liofilizaçäo de leveduras de interesse industrial: influência das condiçöes de cultivo, velocidade de congelamento e meio protetor, na viabilidade celular após a liofilizaçäo / freeze-drying of industrial yeast strains: influence of growth conditions, coolong rates and suspending media on the viability of recovered cells

Dez linhagens de leveduras empregadas na produçäo de etanol no país foram estudadas, visando a obtençäo de maiores níveis de viabilidade celular após a liofilizaçäo.Foi testada a influência de três parâmetros:condiçöes de cultivo, velocidades de congelamento e meio protetor.Nos dois protetores testados, células cultivadas em meio sólido mostraram-se mais resistentes aos congelamentos rápido e lento do que aquelas crescidas sob agitaçäo.A velocidade de congelamento em si parece näo ser o único fator de morte celular.Engtretanto, os melhores resultados de viabilidade após a liofilizaçäo foram obtidos quando o congelamento lento foi previamente empregado.O emprego do congelamento rápido a células oriundos de culturas agitadas mostrou uma grande perda em viabilidade, evidenciada apenas após a liofilizaçäo.Assim sendo, embora esta forma de congelamento näo pareça causar perdas, o mesmo, quando associado a células cultivadas em shaker foi responsável pelos mais baixos valores de viabilidade celular.

[Prevalence of bronchial asthma in a student population in Guadalajara City, Jal. México]. / Prevalencia del asma bronquial en población escolar en la ciudad de Guadalajara, Jal. México.

In an intent to know the bronchial Asthma prevalence in our school children we performed a prospective descriptive survey of 1064 children. The diagnosis was confirmed by clinical history, physical examination and skin test. We found an accumulative prevalence of 12.8% with predominance in males. The 93.4% had confirmed diagnosis, the 30% had need for hospitalization in the last school year. We also analyze the age of onset, family history of allergy and school absenteeism. Bronchial asthma is a common ill at school age, affecting school attendance and family habits and finances.

Treatment of chronic prostatitis: intraprostatic antibiotic injections under echography control.

We treated 51 patients diagnosed as having chronic bacterial prostatitis (gram-negative) with 2 ml. intraprostatic amikacin (500 mg.) or tobramycin (100 mg.) weekly for 2 to 4 weeks. Administration was perineal with echographic control and injection was done in the echogenic zone or external gland. In each case the diagnosis was obtained by fractioned microbiological study via the method of Meares and Stamey. This test was repeated 4, 12 and 24 weeks after the end of treatment. Of the patients 25 (49 per cent) were cured microbiologically, 11 (21.5 per cent) were cured after a second cycle of treatment and the remaining 15 (29.4 per cent) failed to respond. The clinical cure rate was 43.1 per cent and 41.1 per cent of the patients were improved. After 6 months 5 patients had relapse and 1 had reinfection. No differences were observed with both antimicrobials. The microbiological cure indexes of 70.5 and 58.8 per cent after 3 and 6 months, respectively, compared favorably with that obtained by oral therapy with antimicrobials that reach effective levels in the prostatic fluid. Transitory post-injection hemospermia was observed in 11 patients. Together with pain during or after injection (8 and 5 patients, respectively), these were the sole adverse effects observed with this therapy.

A variant of cerebral glioma called pleomorphic xanthoastrocytoma: case report.

A newly recognized type of cerebral astrocytoma has been described in the last 5 years among patients under the age of 30. The designation of pleomorphic xanthoastrocytoma has been suggested for this neoplasm on the basis of its unique histological features. These include abundant lipid droplets in the astrocytic cytoplasm. We report an additional case of this cerebral hemisphere astrocytoma, which (in common with 17 others reported before) occurred in a young patient. His postoperative course has been benign and he remains ambulatory and almost symptom-free 9 years after the initial tumor excision. The diagnosis of pleomorphic xanthoastrocytoma should be entertained in patients in whom a superficially placed intracerebral tumor (i.e., one that seems to be in contact with the meninges) develops during the juvenile years.

Oligodendrogliomas / Oligodendrogliomas

En nuestra serie de 805 tumores cerebrais confirmados histológicamente de 1974 a 1984 encontramos 24 oligodendrogliomas, lo cual corresponde al 2,9% de todos los casos. De ellos había 13 hombres y 11 mujeres con edad prometido de 19 años para los hombres y 35 para las mujeres con rango entre 19 y 69 años. La mayor parte estaban localizados en el lóbulo frontal. La duración de los síntomas pre-operatorios osciló entre 1 día y 15 años. Los principales síntomas fueron convulsiones, cefalea y transtornos del comportamiento, cuando estas se asociaron con calcificaciones demostradas por rayos X símples o escanografía. En un enfermo de 30 a 50 años de edad el diagnóstico muy problemente es de oligodenglioma